Will Celexa work if Lexapro didn’t? (5+ factors)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will explore whether Celexa would work if Lexapro didn’t. Furthermore, we will discuss the comparison between Celexa and Lexapro, the contributing factors, and how is Celexa beneficial compared to Lexapro.
Will Celexa work if Lexapro didn’t?
Celexa may work if Lexapro does not work for some individuals in treating depression. Celexa and Lexapro both belong to the same class of drugs that is selective serotonin reuptake inhibitors (SSRIs). Both Celexa and Lexapro are effective antidepressants, however, one may work for some individuals while the other does not.
Celexa and Lexapro work by inhibiting the reuptake of serotonin, a chemical neurotransmitter in the synaptic regions of the brain. Serotonin regulates sleep, mood, appetite, and the body’s stress response (1,2).
How is Celexa compared to Lexapro?
The comparison between Celexa and Lexapro is discussed in detail below:
Therapeutic uses
Celexa is FDA-approved to treat depression in adults 18 years and older. However, in clinical settings, it can be used to treat obsessive-compulsive disorder, generalized anxiety disorder, panic disorder, and other related mental disorders (1).
On the other hand, Lexapro is FDA-approved to treat major depressive disorder and generalized anxiety disorder in pediatric patients and adults. Lexapro can also be used to treat panic disorder, premenstrual dysphoric disorder, or post-traumatic stress disorder (PTSD) (2).
Dosage recommendations
Celexa is available in 10mg, 20mg, and 40mg tablets and an oral solution of 10mg/5ml. Celexa is started at an initial dose of 20mg and a maximum dose of 40mg taken once a day with or without food (1).
On the other hand, Lexapro is available in 5mg, 10mg, or 20mg tablets and an oral solution of 1mg/ml. The starting dose of Lexapro is 10mg and the daily maximum limit is 20mg with or without food (2).
Side effects
Some common side effects associated with Celexa and Lexapro are quite similar such as nausea, diarrhoea or constipation, drowsiness, fatigue, weight changes, insomnia, dry mouth, and sexual side effects (1,2).
What are the contributing factors for Lexapro’s ineffectiveness?
The contributing factors for Lexapro’s ineffectiveness may include the following:
Genetic variations
People may vary from one another in their genetic makeup. They may also differ in how their bodies respond to the medications. Lexapro being an effective antidepressant may not be suitable for some individuals as they do not respond well (3).
Delayed onset of action
Antidepressants like Lexapro may not show improvement in the early phase of treatment. When patients do not observe any improvement in the initial phase, they may stop taking Lexapro which may lead to its ineffectiveness.
Sudden discontinuation of Lexapro is not advisable as it may also lead to withdrawal symptoms. However, Lexapro may take up to 4 to 6 weeks to show its complete therapeutic effects (4).
Underlying health conditions
Lexapro alone may be ineffective for individuals who have other underlying medical conditions along with depression. In a comorbid condition such as bipolar depression, Lexapro should be administered in combination with mood stabilizers to be effective (5).
Drug interactions
Lexapro when used along with medications that may interact with it, leads to its ineffectiveness. Despite being an effective antidepressant, Lexapro may cause a rare but life-threatening condition known as serotonin syndrome, when taken in combination with medicines such as dextromethorphan and rasagiline (6,7). Therefore, it is necessary to inform your healthcare provider about the medications you are using, even if they are over-the-counter medications.
Non-adherence to treatment plan
When Lexapro is not taken as per the doctor’s recommendation, it may lead to its ineffectiveness. Skipping the doses, not taking them at the same time every day, or sudden discontinuation may lead to Lexapro’s ineffectiveness and may also cause withdrawal symptoms (8).
Environmental factors
Some external factors such as stressful situations, lifestyle, societal pressure, or inadequate support from loved ones, may also lead to the antidepressant’s efficacy. In such cases, therapies like cognitive behavioural therapy (CBT) might be useful for patients (9).
How is Celexa beneficial compared to Lexapro?
Celexa may be beneficial for patients who do not respond well to Lexapro. Some patients may experience better tolerance to Celexa and may have lower side effects and improvement in depression symptoms compared to Lexapro.
These variations among individuals may be due to their genetic makeup and physiological response to Lexapro. Celexa is a generic medication, therefore its access and availability might not be an issue in certain regions compared to Lexapro which is a brand medication.
Some healthcare providers may also prefer to recommend Celexa over Lexapro, due to certain reasons such as their personal experience with Lexapro, patients’ family or medical history.
As per my research analysis, Celexa might be considered as an alternative to Lexapro. Lexapro despite being an effective antidepressant, may not be suitable for some individuals due to some factors that may lead to its ineffectiveness.
Therefore, your healthcare provider must evaluate your overall condition, family or medical history, and response to the medication during antidepressant treatment and take the decision accordingly. Do not change or stop taking your medicines without consulting your healthcare provider.
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References
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Sharbaf Shoar N, Fariba KA, Padhy RK. Citalopram. 2023 Nov 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 29489221. Available from: https://pubmed.ncbi.nlm.nih.gov/29489221/
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Landy K, Rosani A, Estevez R. Escitalopram. 2023 Nov 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32491666. Available from: https://pubmed.ncbi.nlm.nih.gov/32491666/
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GENDEP Investigators; MARS Investigators; STAR*D Investigators. Common genetic variation and antidepressant efficacy in major depressive disorder: a meta-analysis of three genome-wide pharmacogenetic studies. Am J Psychiatry. 2013 Feb;170(2):207-17. doi: 10.1176/appi.ajp.2012.12020237. PMID: 23377640; PMCID: PMC10416089. Available from: https://pubmed.ncbi.nlm.nih.gov/23377640/
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Fonseca M, Soares JC, Hatch JP, Santin AP, Kapczinski F. An open trial of adjunctive escitalopram in bipolar depression. J Clin Psychiatry. 2006 Jan;67(1):81-6. doi: 10.4088/jcp.v67n0115. PMID: 16426092. Available from: https://pubmed.ncbi.nlm.nih.gov/16426092/
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Dy P, Arcega V, Ghali W, Wolfe W. Serotonin syndrome caused by drug to drug interaction between escitalopram and dextromethorphan. BMJ Case Rep. 2017 Aug 7;2017:bcr2017221486. doi: 10.1136/bcr-2017-221486. PMID: 28784915; PMCID: PMC5747823. Available from: https://pubmed.ncbi.nlm.nih.gov/28784915/
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Suphanklang J, Santimaleeworagun W, Supasyndh O. Combination of Escitalopram and Rasagiline Induced Serotonin Syndrome: A Case Report and Review Literature. J Med Assoc Thai. 2015 Dec;98(12):1254-7. PMID: 27004312. Available from: https://pubmed.ncbi.nlm.nih.gov/27004312/
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Yasui-Furukori N, Hashimoto K, Tsuchimine S, Tomita T, Sugawara N, Ishioka M, Nakamura K. Characteristics of Escitalopram Discontinuation Syndrome: A Preliminary Study. Clin Neuropharmacol. 2016 May-Jun;39(3):125-7. doi: 10.1097/WNF.0000000000000139. PMID: 27171568. Available from: https://pubmed.ncbi.nlm.nih.gov/27171568/
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Gingnell M, Frick A, Engman J, Alaie I, Björkstrand J, Faria V, Carlbring P, Andersson G, Reis M, Larsson EM, Wahlstedt K, Fredrikson M, Furmark T. Combining escitalopram and cognitive-behavioural therapy for social anxiety disorder: randomised controlled fMRI trial. Br J Psychiatry. 2016 Sep;209(3):229-35. doi: 10.1192/bjp.bp.115.175794. Epub 2016 Jun 23. PMID: 27340112. Available from: https://pubmed.ncbi.nlm.nih.gov/27340112/
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